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ELEGTRICA�_ PERMIT APPLICATION <br /> Ci7Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, CVERETI', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE laCCEPTED FROM 8 AM TO 4 PM —� � z _p� <br /> G''U7c'�-c'�'� <br /> __-;o ,D r_�'�� �i.�. �� �, `/ <br /> PROJECT ADDRESS � <br /> �`�j�j'.,, �•:�;�.- yc),7l� rucr�-.•<. � wnY t?ven-.�,L �, `Z'P1n3 <br /> Owne� � M1".ail Address City State/Zip Phone <br /> S�SpyLS . 6a9.=D Eucr,/b<..i wnY =i.ereat r�a fY2D3 <br /> Tenant Mail Address Cily State/Zip Phone <br /> f_�t,� (70�fAcv �1'�frin �r�ri RB7� /f a/S A�;// �/;-'��L G�fl /�O�'oz /1S-7i:v�6 f <br /> Eleclrical Contraclor Mail Address City SlalelZip Phone <br /> �nl✓vnl/.` 4,�C .�F:� �.'> roo <br /> State Licerse Number Conlract Price of Work <br /> , �r:�c �it1.�i1.3�i�e�.s <br /> Proposed Use of 6ui�ldlin�g Contact Person (P�an Review) <br /> Descriplion of Work to Be Done: f��y<7// r�Rc c%-�w��� ��..<!c,-. <br /> NOTE: WIRIPJG IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERET7 LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily Ihat 1 have read and examined this applicafion and kno�r fhe same te be(rue and <br /> correcL All provisions o/laws and ordinances govemmg this type ol work will be completed <br /> wbefher specilied herein cr net. The granting ol a permd does not reswne ro give authorily to <br /> violate or cancel fhe provisions ol any other sfate or local la�v reguPling construcfion or the <br /> performance o�construction. Tha;1 am aulhorized by the owner of Ihis properfy to per(orm(he <br /> work/or which application is made and 1 comply�vilh the State Con(raclors Laro 18.27 RCW and <br /> 296.200 WAC. <br /> �7� �� . � 2 �� �0� � � <br /> SignaWre� Date <br />